Clinical Profile of Thoracoscopic Bullectomy in Treatment of Pneumothorax.

Pratima Gautam, Ranjan Sapkota, Suraj Shrestha, Prakash Mainali
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Abstract

Background: In pneumothorax patients requiring surgery for various indications, thoracotomy was the traditional approach until the advent of video-assisted thoracoscopic surgery. In the last decade, role of thoracoscopy in the surgical management of pneumothorax has been consolidated and established. In this study, we aim to report our experience of thoracoscopy in the surgical management of pneumothorax.

Methods: A descriptive review of prospectively maintained data on all the patients undergoing thoracoscopic bullectomy for pneumothorax was done.

Result: Over the period of 9 years, a total of 120 patients underwent thoracoscopic bullectomy. Among them, 95 entered final analysis. Most common age group was 21-40 years, with male predominance (80%); most common diagnosis was primary pneumothorax (67%), first episode (74%), and on the right (65%) side; commonest symptom was shortness of breath (84%) of a median duration of 7 days. A chest tube was placed in 96% of patients before the operation. Commonest radiological finding was multiple bullae (45%) in the apical region (71%). Majority of patients underwent surgery via 3 ports, and a single bulla in the apical region was the most common intraoperative finding. Among the postoperative complications which occurred in 17%, an air leak was present in 9%. The median intensive care stay was 23 hours, the median chest tube duration was 3 days, and the median hospital stay was 9 days.

Conclusions: Thoracoscopy can be used as a safe, feasible, and effective procedure in patients presenting with pneumothorax with minimal postoperative complications.

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胸腔镜球囊切除术治疗气胸的临床概况
背景:在视频辅助胸腔镜手术出现之前,因各种适应症而需要手术治疗的气胸患者一直采用传统的开胸手术。近十年来,胸腔镜在气胸手术治疗中的作用得到了巩固和确立。在本研究中,我们旨在报告胸腔镜在气胸手术治疗中的经验:方法:对所有接受胸腔镜气胸球囊切除术的患者的前瞻性数据进行描述性回顾:结果:9年间,共有120名患者接受了胸腔镜气胸球囊切除术。结果:9 年间,共有 120 名患者接受了胸腔镜气胸切除术,其中 95 人进入最终分析。最常见的年龄组为 21-40 岁,男性占多数(80%);最常见的诊断为原发性气胸(67%),首次发作(74%),右侧(65%);最常见的症状为气短(84%),中位持续时间为 7 天。96%的患者在手术前放置了胸管。最常见的放射学发现是心尖区(71%)的多发性鼓包(45%)。大多数患者通过 3 个孔进行手术,术中最常见的发现是心尖区有一个鼓包。术后并发症发生率为 17%,其中 9% 出现漏气。中位重症监护时间为 23 小时,中位胸管插管时间为 3 天,中位住院时间为 9 天:结论:胸腔镜手术对气胸患者来说是一种安全、可行且有效的治疗方法,术后并发症极少。
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来源期刊
CiteScore
1.40
自引率
0.00%
发文量
81
审稿时长
15 weeks
期刊介绍: The journal publishes articles related to researches done in the field of biomedical sciences related to all the discipline of the medical sciences, medical education, public health, health care management, including ethical and social issues pertaining to health. The journal gives preference to clinically oriented studies over experimental and animal studies. The Journal would publish peer-reviewed original research papers, case reports, systematic reviews and meta-analysis. Editorial, Guest Editorial, Viewpoint and letter to the editor are solicited by the editorial board. Frequently Asked Questions (FAQ) regarding manuscript submission and processing at JNHRC.
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